A Guide to Nova Scotia's Medical Services Insurance & MSI Health Card

Read on to learn more about Nova Scotia health plan, the eligibility requirements, ways to obtain a health care card, and more. If you are a permanent resident of Nova Scotia, you should know how to take advantage of Nova Scotia’s healthcare benefits.

    Canada is known as one of the best places to live because of its free medical health care program – all Canadians have access to medical care regardless of their ability to pay medical expenses. Their health care is publicly funded by both the provincial and federal governments. The Nova Scotia MSI (Medical Services Insurance) Plan is the provincial health plan for all provincial residents that provides coverage for basic health care needs.

    Free Healthcare Coverage in Nova Scotia

    The Nova Scotia government has a health coverage plan that is offered through the MSI provincial health plan. In order to register, you must live in the province for at least six months per year and provide proof you have an address there. As a permanent resident, you are eligible to apply for health coverage the day you arrive. If you have a work permit of at least 12 months, you can apply the day you arrive. As a student, you are not eligible to get MSI until you’ve lived in the province for at least 12 months (and can apply for health coverage at the beginning of the 13th month).
    Nova Scotia MSI Program is designed to provide coverage for medically required hospital services, optometry services, and dental services (with some restrictions) to all eligible residents.

    Nova Scotia MSI free health care coverage insurance can be supplemented by purchasing additional health insurance or a hospital insurance program from private insurance companies.

    MSI Coverage

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    What Does Nova Scotia MSI Cover?

    The Nova Scotia MSI Program is a federal health coverage program designed to supply all eligible Nova Scotia residents with free, fundamental medical benefits. Once you become a registered Nova Scotia health cardholder, the MSI program will provide:

    • Basic health care services (emergency room visits, doctor’s office visits, and medically required hospital stays)
    • Dental care (yearly checkups, cleanings and fillings, as well as standard dental services for children under the age of 14)
    • Physiotherapy (if deemed medically necessary and if occurs in a hospital setting)
    • Vision care (one visit to the optometrist every two years for those younger than 9 and older than 65 years of age)
    • Standard hospital ward rooms
    • Home care coverage (only if you qualify)

    Nova Scotia MSI will not cover a great number of valuable medical services, such as:

    • Prescription drugs
    • Ambulance (unless the transportation occurs between approved facilities, you will be charged a flat rate of $142)
    • Orthotics
    • Chiropractic, podiatrist, naturopath, massage therapy and osteopath services
    • Glasses and contact lenses
    • Hearing aids
    • Extensive dental care
    • Upgraded hospital stays
    • Accidental death and dismemberment

    What Does Nova Scotia Family Pharmacare Cover?

    Nova Scotia’s provincial drug insurance plan that’s designed to help its residents with the cost of prescription drugs is called the Nova Scotia Family Pharmacare Program. It offers assistance with the cost of pharmaceutical drugs for families that have no drug coverage or cannot financially cover the cost of prescription drugs. All Nova Scotians with a valid Nova Scotia Health Card can access this program.

    Besides having a valid Health Card, to be eligible for this program, you must agree to provide family size information and family income verification via Canada Revenue Agency each year.

    The prescription drugs, supplies, and other related services that the Family Pharmacare Program covers are listed in the Nova Scotia Formulary.

    What Does Nova Scotia Seniors Pharmacare Cover?

    The Nova Scotia Seniors’ Pharmacare is a provincial drug insurance program that provides assistance to senior eligible residents with the cost of their prescription drugs. All who wish to be eligible residents for the Seniors Pharmacare help, must:

    • Live in Nova Scotia
    • Have a valid Health Card
    • Not have prescription drug coverage under other programs or plans, and
    • Be at least 65 years old

    When you enroll in the program, your Nova Scotia Health Card also becomes your Pharmacare Card. You’ll proceed to pay an annual premium according to your household income, as well as annual co-payment either directly to the Seniors’ Pharmacare Program or at the pharmacy. Both the co-payment and the premium have their annual maximums and the Nova Scotia province will cover the rest. Use the online calculator.

    MSI for Students

    Nova Scotia medical coverage is the same for students. Students in Nova Scotia will receive MSI coverage if they meet the following eligibility requirements:

    • Minimum 12-month study period
    • One year wait period
    • Apply on the first day of the thirteenth month following your arrival as a student
    • Must not be out of the province for more than 31 consecutive days
    • Proof of study permit required
    • Learn more: How to apply for a health card in Nova Scotia

    Registering for Nova Scotia MSI

    Nova Scotians who wish to register for MSI can do so by either visiting or calling the MSI office to complete your application form. You’ll be required to present your proof of citizenship or immigration status for the application process. Once your application is processed, you and each of your family members will receive a Nova Scotia MSI Health Card.

    In order to be eligible for MSI benefits, you must be:

    • a resident who makes a permanent home in the province of Nova Scotia
    • a permanent citizen (landed immigrant) or a Canadian citizen
    • present in Nova Scotia 183 days per year
    • registered with MSI

    Those not eligible for MSI coverage are:

    • students from another province
    • tourists and visitors
    • inmates of federal penitentiaries
    • members of the Canadian Armed Forces (as for their family members, they are eligible)

    Full-time students from other provinces aren’t eligible for the Nova Scotia MSI benefits and their home province will continue to provide health coverage during their entire studying period. To ensure your coverage is maintained, please contact your home province.

    Applying for a Nova Scotia MSI Health Card

    MSI Health Card

    The Nova Scotia MSI Health Card is a personal identification card which you are required to present in order to receive medical services. If you are eligible to apply for your Health Card, you should gather the necessary documents to accompany your application, and start your application. Once you have completed it and it’s been received at the SMI Registration Department, you will receive your Health Card by mail in 10 business days.

    For more information about applying for a Nova Scotia Health Card, you can find help at your nearest newcomer services or community agency. You can also contact MSI via email (MSI@medavie.ca), toll-free 1-800-563-8880, or telephone (902-496-7008).

    How to Apply in Person

    To apply in person for a NS Health Card, you will need to reach out to the MSI Registration and Enquiry Department directly.

    Telephone: 902-496-7008

    Toll-free: 1-800-563-8880

    PO Box 500, Halifax, NS, B3J 2S1

    230 Brownlow Avenue, Dartmouth, NS

    Applying Online

    Nova Scotia residents cannot apply online for their Health Card.

    Forms and Documentation Required

    • Provide Proof of Canadian citizenship
    • Proof of your immigration status (e.g., work permit, landed immigrant, permanent resident)

    Renewing or Replacing Your Nova Scotia MSI Card

    Renewing Your Health Card

    Every Health Card comes with an expiry date - a four-year term which is determined by your birth month. For example, if your birthday is September 12, and you obtained your Health Card in 2018, the expiry date of your Health Card would be August 31, 2022). Three months before this expiry date, you will receive your Health Card Renewal form. This update request you have to complete, sign, and send back to MSI. Your health coverage insurance will be renewed once the form is received and processed, and MSI will send you a new card. You can download the Health Card Renewal form here or get it by calling the MSI office.

    Replacing Your Card

    In case your Health Card gets damaged, stolen, or lost, or your need to report, you should reach out to MSI. To replace a stolen or lost card, you will need to pay a $10 fee.

    Changing the Address on Your Card

    In case there are changes in your personal and family info (e.g., new address, divorce, legal separation, birth, death, or adoption) your need to provide MSI with up-to-date information. Visit the Government Online Services Website to notify MSI of your change of address online.

    Nova Scotia MSI Coverage Details

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    All permanent residents of Nova Scotia (residing in the province for at least 183 days each year) have access to provincial health coverage. Keep reading to find out more about what’s covered and what isn’t covered by the health plan, as well as about extended health care, drug plan, coverage for those travelling in and out of Canada.


    When it comes to dental benefits, Nova Scotia MSI doesn’t cover routine dental services. However, it does offer certain dental programs designed to help eligible people access dental care:

    Children’s Oral Health Program – provides coverage for basic dental services to children up to 14 years of age. However, it doesn’t cover all preventative dental services.

    Oral and Maxillofacial Surgery Program – provides coverage for medically necessary oral/maxillofacial surgical services (delivered in-hospital) such as: dental surgery (surgical operation and pre/post-operative care) and in-hospital consultations requested by a dental/oral maxillofacial surgeon or physician.

    Maxillofacial Prosthodontics Program – provides coverage for residents who need rehabilitation of head and neck deficits.

    Individuals with Special Needs Oral Health Program – provides coverage for basic dental needs of residents diagnosed with an intellectual disability (which requires in-hospital dental care under a general anesthetic).

    Cleft Palate/Craniofacial Program – provides coverage for residents with craniofacial anomalies.

    Exceptional Circumstances – coverage for which dentists may apply on behalf of their patients who need medically necessary services that aren’t covered by any Dental Program. Patients must rely on their private dental insurance before the coverage under Exception Circumstances will be considered and approved.

    There is no coverage for the aforementioned programs if dental services are performed outside of the province of Nova Scotia.

    Dental Costs With MSI

    Nova Scotia MSI Health Plan will cover or partially cover only certain dental procedures. In case you need dental services that are not covered by MSI, you will need to supplement your health plan with additional dental insurance.

    Prescription Drugs

    Pharmacare Programs are a medical services insurance program that Nova Scotians have in order to access different public drug plans. They are designed to help residents with the cost of prescribed drugs (indicated as benefits in the Nova Scotia Formulary) and with the cost for certain services.

    Seniors' Pharmacare Program - available to residents 65 years of age and older.

    Family Pharmacare Program - available to anyone with a valid Nova Scotia Health Card and helps families without prescription drug coverage or with the cost of drugs they cannot afford due to low household income.

    Drug Assistance for Cancer Patients - available to residents diagnosed with cancer and an income less than $25,500.

    Palliative Care Drug Program - available to residents and intended for use in end-of-life care at home.

    Department of Community Services Pharmacare Benefits – provides drug coverage to Disability Support Program clients, Income Assistance clients, Low Income Pharmacare for Children clients, and children in the care of child welfare.

    Prescription Drug Costs with Nova Scotia Pharmacare

    To determine allowable mark-ups, maximum professional fees, definitions of cost that pharmacies are allowed to charge for prescriptions, the Pharmacy Association of Nova Scotia negotiates with the Nova Scotia Department of Health and Wellness.

    Nova Scotia’s Pharmacare Programs pay the manufacturer's list price (MLP) or actual acquisition cost (AAC) for all drugs submitted to them, unless the drug has been assigned a Pharmacare Reimbursement Price (PRP) or a Maximum Reimbursable Price (MRP). Also, the Pharmacare Programs pay a markup on the cost and the professional fee.

    Extended Health Care

    Extended health coverage provided by the Nova Scotia Medical Services Insurance plan includes programs such as:

    • Drug Assistance for Cancer Patients
    • Nova Scotia Diabetes Assistance Program
    • Insulin Pump Program

    Coverage when Travelling in Canada

    If you are travelling through Canadian provinces, all of them have signed the Reciprocal Billing Agreement, except Quebec for physician services. All you have to do is to show your Nova Scotia Health Card to the medical service provider, and everything will be reimbursed to your home province. In case the medical service provider requires you to pay for services, be sure to submit the receipt to MSI for consideration.

    In case you plan to be absent from Nova Scotia for more than three months, you should contact MSI at msi@medavie.ca or 902-496-7008 or 1-800-563-8880 (toll free within Nova Scotia) for advising on:

    • the date you plan to leave the province
    • the intended return date
    • the reason for your absence

    The period and extent of your health coverage will vary according to the reason and circumstances of your absence.

    Prescription drugs purchased in another province are paid only under exceptional circumstances.

    Coverage when Travelling Out of Canada

    When travelling out of Canada, MSI will provide you with health coverage for emergency medical services.

    Canadian funds will cover for:

    • Out-of-country in-patient hospitalization that occurred due to sudden illness or accident during your temporary absence.
    • Physician Services required due to sudden illness or accident during your temporary absence.

    While out of Canada, the MSI program will not cover the following services:

    • Routine vision analysis
    • Pharmacare and Children’s Dental Programs
    • Diagnostic tests, x-ray, and laboratory charges from private, emergency, or out-patient facilities.

    For any resident planning to travel out of province, it is strongly recommended to purchase a Travel Health Plan or a Hospital Insurance Program for their period of absence in order to cover other services.

    Common Procedures and MSI Coverage Eligibility

    There is much confusion regarding the Nova Scotia MSI Plan and the extent of the coverage. The following are common diagnostic services or procedures that aren’t covered by the Nova Scotia Health Plan.

    What Is and Isn't Covered Under MSI

    X-Rays and Exams In approved facilities when ordered by a physician
    Wisdom teeth No
    Eye exams One visit to the optometrist every two years for those younger than 19 and older than 65 years of age.
    Glasses No
    Laser eye surgery No
    Rhinoplasty Yes, if recommended by a doctor for medical reasons and with an approval from MSI
    Breast reduction Yes, if recommended by a doctor for medical reasons and with an approval from MSI
    Hospital stays Yes
    Ambulance transportation No
    Giving birth Yes
    Sexual Health
    Gynecologist Yes
    Erectile dysfunction No
    Birth control (including IUD) Yes
    Fertility treatment Yes
    Dermatologist Yes
    Physiotherapy Yes
    Massage therapy No
    Podiatrist and foot care No
    Allergist and allergy testing Yes
    Sleep physician and CPAP machines Yes

    Extending MSI Health Plan Coverage

    Nova Scotia provincial health coverage grants its residents access to basic medical services at no cost. But when it comes to specific services (such as dental care, home care, hearing health care, prescription drugs, optometrist exams, etc.), the provincial health plan requires co-payment on a personal insurance plan.

    Although Nova Scotia residents can receive essential medical benefits, there is still a lot of ground left uncovered. The Insurdinary health insurance plan will provide coverage for various medical emergencies and everyday health needs. Our supplemental personal insurance health plan is there to fill the gaps that are left by the provincial health plan.

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    Sources and references:

    • https://novascotia.ca/DHW/msi/health_cards.asp
    • https://novascotia.ca/DHW/msi/eligibility.asp
    • https://novascotia.ca/DHW/msi/moving_travel.asp
    • https://novascotia.ca/dhw/provincial_programs.asp
    • https://novascotia.ca/dhw/msi/
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